NSCLC Highlights From ESMO 2019

Tony Mok, MD

Disclosures

October 22, 2019

Key studies on non–small cell lung cancer (NSCLC), presented at the 2019 annual meeting of the European Society for Medical Oncology (ESMO), updated the results of landmark phase 3 trials involving tyrosine kinase inhibitors (TKIs) and immunotherapies.

Dr Tony Mok reviews data from the FLAURA study on the use of osimertinib, a third-generation TKI, in a first-line setting. Previously published results showed a significant benefit in progression-free survival (PFS), from 11 months to 18.9 months. The current overall survival (OS) data were similarly positive, with a median OS of 38.6 months versus 31.8 months.

Two immunotherapy trials are also reviewed. The first is the IMpower110 study, which compared the single-agent anti-PD-1 inhibitor atezolizumab versus chemotherapy alone. While atezolizumab is often used in combination with chemotherapy, checkpoint inhibitor monotherapy is preferred for many patients. The study found a significant benefit in OS for some subgroups.

The second immunotherapy study discussed is CheckMate-227. This large, multiarm study looked at the efficacy of combining a PD-1 inhibitor (nivolumab) with an anti-CTLA4 agent (ipilimumab). The two immunotherapies have complementary mechanisms of action and were previously shown to improve survival in other cancer types. Data presented here on the combination of nivolumab and lose-dose ipilimumab showed an OS benefit over chemotherapy in all patients who were randomly assigned, regardless of their PD-L1 status.

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